Medicare Part D created a storm of confusion for consumers, and pharmacists were in the center of it. Four out of five of the Drug Topics readers who participated in a recent survey about the drug benefit's implementation said it brought "utter chaos" into their workplace. Increased workloads, interminable calls to sponsor help centers, and consumer confusion leading to consumer anger were the norm in pharmacies last January.

"It caused a complete disruption of the normal flow in my pharmacy," said one respondent in written remarks accompanying the submitted surveys. "Patients were cursing at us, saying that it was all our fault," said another. "We had men and women in tears."

How well trained were you?

"The insurance companies were not prepared. The processors were not prepared. CMS [Centers for Medicare & Medicaid Services] was not prepared," griped a pharmacist. "Their being ill-prepared caused chaos for the pharmacists, who could not do their job. It was pitiful."

To make it worse, Part D has had a serious negative effect on cash flow: More than half (56.4%) of respondents said they experienced money problems because of Part D. Of those, nearly a third (30.8%) said that the problems were "very serious." Many pharmacists reported taking out loans or extending lines of credit, and several said their wholesalers had to provide short-term extensions on their bills. "I am using my personal savings to keep afloat," said a pharmacist.

How many patients sought help?

Such comments were typical of what we received in February from the 420 community pharmacists who responded to an on-line survey we sent to 3,234 pharmacists selected randomly from Drug Topics' mailing list, representing a statistically valid response rate of 7.7%.

We wanted to know how our readers fared in January's implementation of the biggest transformation in healthcare delivery since Medicare began 41 years ago.